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ID CARDS
Mar 20, 2007

  HEARTSONG CENTER
CANNABIS SUPPORT GROUP of 
The United States of
America.                                                                                                                                                                                                                                                             

Application for Full Membership

To be completed by the Member. 
Full Name:                                                                                                      
 
Email Address: 
 Condition / Complaint:   
Do you have any psychological or other conditions that can be exacerbated by the use of cannabis?                 Yes/No   
Please include any relevant information or doctors / specialists letters with this application form.
From time to time we are contacted by the media wanting people to talk to.   Would you be prepared to speak to the media even anonymously?     YES       NO   (circle one)
I am not a member of, nor will I give any Heartsong information to, any law enforcement agency.
I agree to pay $20.00 for the initial membership fee then $10.00 per year to renew; this covers the cost of the ID card.
 If arrested we advise you to enter ‘no plea’ and contact Heartsong
IN SIGNING THIS APPLICATION FORM I DECLARE THAT I HAVE ANSWERED ALL THE INFORMATION TO THE BEST OF MY KNOWLEDGE TRUTHFULLY ACCURATELY.    
This form is for implementation of Proposition 215, the Compassionate Use Act of 1996, and Measure B. The purpose of this voluntary identification card program is to help law enforcement officers identify individuals whose possession of cannabis is permissible under Health and Safety Code Section 11362.5. This form shall not be used to assist anyone in obtaining or gaining access to cannabis.
Signature:    X                                                                                 Date:    
If my person chooses to use cannabis therapeutically, I intend to continue to monitor his/her Spiritual  condition and to provide advice on his/her progress.
   
This certifies that the above is a person under  their own care and supervision. I certify that this person has a dis-order which may benefit from the use of cannabis treatment. And as the Elder of our Church I find no trouble letting them do as they wish.
      This section to be completedby a Church Official 
Full Name:      
Date of Birth:                                                                        
Address:
Card #: 
In your opinion do you believe cannabis will benefit your health and if so how?  Heartsong would educate the patient on the safest vaporisation or ingestion methods. With this in mind, is it likely that the benefits of controlled cannabis use for this patient will outweigh any possible negative effects?.  Would you like to become a volunteer / supporter of Heartsong?          Yes           No 
SIGNED X                                                                                              DATE  ·        By signing this application form you have agreed that every answer you have given is accurate to the best of your knowledge.·      
  This information is kept totally confidential within HEARTSONG CANNABIS SUPPORT GROUP of UNITED STATES OF AMERICA.THANK YOU for completing this Supporting Application and the questions contained within it. We at HEARTSONG CANNABIS SUPPORT GROUP of UNITED STATES OF AMERICA appreciate your comments and also appreciate your taking the time to help us and your patient. This information is kept confidential by HEARTSONG CANNABIS SUPPORT GROUP of UNITED STATES OF AMERICA and is used for membership and  information on the diseases and conditions that the use of cannabis may be able to help with.



GATHER WITH US IN SPIRITUAL UNITY FOR THE PURIFICATION OF LAND AND LIFE

 Phone 715-529-0771

FACILITIES INCLUDE: Natural mineral hot-springs fed baths and enormous pool, camping landsites for sleepers, tents, and mobile living vehicles, very limited hotel space, fine vegetarian meals from natural foods kitchen, and very loving caretakers. Donations to cover gathering expenses are requested by caretakers as follows; CELEBRATION OF LIGHT: CONFERENCE OF THE RAINBOW: Come freely, all donations will be accepted.



CONFERENCE OF THE RAINBOW;: A Spiritual Unity gathering for World Peace and the Cause of paradise on Earth. Representatives of all faiths, religions, and spiritual philosophies are invited to participate as follows;, prayer drums until sun rises, opening ceremonies led by indigenous American Indian religious and spiritual leaders;, respective Spiritual Unity communion ceremonies and sacred rituals led by representatives of various religions and spiritual philosophies;
, Day of Atonement, Ceremony of dying white cotton laboratory coats red; , American Indian Day symposium for speeches to the gathering to be heard from American Indian religious and spiritual leaders;  prepare with unanimous agreement an American-English language typewritten document entitled "Our Hopi (Peaceful Peoples' Proposal for World Peace" for delivery to United Nations on United Nations Day, closing ceremonies started at sunrise by indigenous American Indian religious and spiritual leaders.
E MAIL FOR MORE
twhite@mysticvoices.org
Visibility: Everyone
Posted: Tuesday March 20, 2007, 8:27 am
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Reverend Dr. Timothy White (42) 		Thursday March 22, 2007, 8:42 pm
please sign this and get more people to sign
http://www.thepetitionsite.com/takeaction/437381961

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Reverend Dr. Timothy White
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male, age 108, single
Laytonville, CA, USA
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22
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http://www.thepetitionsit e.com/takeaction/43738196 1


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